Provider Demographics
NPI:1730575655
Name:MICHAEL R GRAY MD PC
Entity type:Organization
Organization Name:MICHAEL R GRAY MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-684-5477
Mailing Address - Street 1:2 W 46TH ST
Mailing Address - Street 2:506
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-4811
Mailing Address - Country:US
Mailing Address - Phone:212-684-5477
Mailing Address - Fax:917-591-1336
Practice Address - Street 1:2 W 46TH ST
Practice Address - Street 2:506
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-4811
Practice Address - Country:US
Practice Address - Phone:212-684-5477
Practice Address - Fax:917-591-1336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-07
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY166679261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty